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Case Reports
. 2020 Jan;99(4):e18805.
doi: 10.1097/MD.0000000000018805.

Anti-GQ1b antibody syndrome presenting with visual deterioration as the initial symptom: A case report

Teng Zhao  1 , Yuyan Deng  2 , Ying Ding  3 , Rensheng Zhang  1 , Chunkui Zhou  1 , Weihong Lin  1
Affiliations
Case Reports

Anti-GQ1b antibody syndrome presenting with visual deterioration as the initial symptom: A case report

Teng Zhao et al. Medicine (Baltimore). 2020 Jan.

Abstract

Rationale: Anti-GQ1b antibody syndrome refers to a distinct variant of Guillain- Barré syndrome. Involvement of the optic nerve in anti-GQ1b antibody syndrome is extremely rare.

Patient concerns: Here, we report a case of anti-GQ1b antibody syndrome presenting with visual deterioration as the initial symptom. A 73-year-old man presented with a 5-day history of bilateral blurred vision and ptosis. He had a previous history of diarrhea starting 10 days before admission. Physical examination showed visual deterioration, ophthalmoplegia, and peripheral facial paralysis. Testing of both serum and cerebrospinal fluid was positive for anti-GQ1b immunoglobulin G antibodies and negative for anti-aquaporin 4antibodies.

Diagnosis: Anti-GQ1b antibody syndrome.

Interventions: The patient was treated with intravenous methylprednisolone and human immunoglobulin.

Outcomes: After a 20-day follow-up, the patient's condition took a favorable turn.

Lessons: This case reminds us that anti-GQ1b antibody syndrome should be suspected in patients with visual deterioration and preceding infection.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Facial and ocular features and fundus examination. (A) The patient's bilateral frontal and nasolabial grooves had become shallow, and the bilateral eyelash signs were positive. (B) The eyes were fixed with limited movement, and ptosis was noted; the pupil diameter in both eyes was 4 mm, and pupillary reaction to light was absent. (C and D) Fundus examination was normal.
Figure 2
Figure 2
Brain magnetic resonance imaging. Brain magnetic resonance imaging showed no abnormality (A and B: axial T2-weighted imaging; C and D: axial T1-weighted imaging; E: sagittal T2-weighted imaging; F: coronal T1-weighted imaging).
See this image and copyright information in PMC

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